TY - JOUR
T1 - Risk of cardiovascular disease morbidity and mortality in frail and pre-frail older adults
T2 - Results from a meta-analysis and exploratory meta-regression analysis
AU - Veronese, Nicola
AU - Cereda, Emanuele
AU - Stubbs, Brendon
AU - Solmi, Marco
AU - Luchini, Claudio
AU - Manzato, Enzo
AU - Sergi, Giuseppe
AU - Manu, Peter
AU - Harris, Tamara
AU - Fontana, Luigi
AU - Strandberg, Timo
AU - Amieva, Helene
AU - Dumurgier, Julien
AU - Elbaz, Alexis
AU - Tzourio, Christophe
AU - Eicholzer, Monika
AU - Rohrmann, Sabine
AU - Moretti, Claudio
AU - D'Ascenzo, Fabrizio
AU - Quadri, Giorgio
AU - Polidoro, Alessandro
AU - Lourenço, Roberto Alves
AU - Moreira, Virgilio Garcia
AU - Sanchis, Juan
AU - Scotti, Valeria
AU - Maggi, Stefania
AU - Correll, Christoph U.
PY - 2017/5/1
Y1 - 2017/5/1
N2 - Frailty is common and associated with poorer outcomes in the elderly, but its role as potential cardiovascular disease (CVD) risk factor requires clarification. We thus aimed to meta-analytically evaluate the evidence of frailty and pre-frailty as risk factors for CVD. Two reviewers selected all studies comparing data about CVD prevalence or incidence rates between frail/pre-frail vs. robust. The association between frailty status and CVD in cross-sectional studies was explored by calculating and pooling crude and adjusted odds ratios (ORs) ±95% confidence intervals (CIs); the data from longitudinal studies were pooled using the adjusted hazard ratios (HRs). Eighteen cohorts with a total of 31,343 participants were meta-analyzed. Using estimates from 10 cross-sectional cohorts, both frailty and pre-frailty were associated with higher odds of CVD than robust participants. Longitudinal data were obtained from 6 prospective cohort studies. After a median follow-up of 4.4 years, we identified an increased risk for faster onset of any-type CVD in the frail (HR = 1.70 [95%CI, 1.18–2.45]; I2 = 66%) and pre-frail (HR = 1.23 [95%CI, 1.07–1.36]; I2 = 67%) vs. robust groups. Similar results were apparent for time to CVD mortality in the frail and pre-frail groups. In conclusion, frailty and pre-frailty constitute addressable and independent risk factors for CVD in older adults.
AB - Frailty is common and associated with poorer outcomes in the elderly, but its role as potential cardiovascular disease (CVD) risk factor requires clarification. We thus aimed to meta-analytically evaluate the evidence of frailty and pre-frailty as risk factors for CVD. Two reviewers selected all studies comparing data about CVD prevalence or incidence rates between frail/pre-frail vs. robust. The association between frailty status and CVD in cross-sectional studies was explored by calculating and pooling crude and adjusted odds ratios (ORs) ±95% confidence intervals (CIs); the data from longitudinal studies were pooled using the adjusted hazard ratios (HRs). Eighteen cohorts with a total of 31,343 participants were meta-analyzed. Using estimates from 10 cross-sectional cohorts, both frailty and pre-frailty were associated with higher odds of CVD than robust participants. Longitudinal data were obtained from 6 prospective cohort studies. After a median follow-up of 4.4 years, we identified an increased risk for faster onset of any-type CVD in the frail (HR = 1.70 [95%CI, 1.18–2.45]; I2 = 66%) and pre-frail (HR = 1.23 [95%CI, 1.07–1.36]; I2 = 67%) vs. robust groups. Similar results were apparent for time to CVD mortality in the frail and pre-frail groups. In conclusion, frailty and pre-frailty constitute addressable and independent risk factors for CVD in older adults.
KW - Cardiovascular disease
KW - Frailty
KW - Meta-analysis
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U2 - 10.1016/j.arr.2017.01.003
DO - 10.1016/j.arr.2017.01.003
M3 - Review article
C2 - 28143778
AN - SCOPUS:85011410570
VL - 35
SP - 63
EP - 73
JO - Ageing Research Reviews
JF - Ageing Research Reviews
SN - 1568-1637
ER -